Department of Medical Examination Center (LR, RL), The First Affiliated Hospital, Chongqing Medical University, Chongqing, China; and Department of Forensic Medicine (LR, JL, RT, SZ, LW), College of Basic Medicine, Chongqing Medical University, Chongqing, China.
Am J Med Sci. 2013 Dec;346(6):455-61. doi: 10.1097/MAJ.0b013e3182926a23.
This study was designed to investigate the efficacy of antitumor necrosis factor(TNF)(a) agents (etanercept, infliximab, golimumab or adalimumab) in ankylosing spondylitis (AS).
A literature search was done using PubMed, Embaseand Cochrane databases. The reference section of all primary studies was inspected for additional references, and only those reporting the results of a randomized-controlled trial comparing etanercept, infliximab or adalimumab with placebo for patients with AS were included in this analysis.
Eleven trials with 1851 patients were included. Compared with placebo, anti-TNF(α) agents was associated with significantly higher rates of Assessment in Ankylosing Spondylitis (ASAS) 20 responders (risk ratio [RR]: 2.45, 95% confidence interval [CI]: 2.13-2.82; P < 0.00001), ASAS 50 responders (RR: 3.77, 95% CI: 2.87-4.95; P < 0.00001), ASAS 70 responders (RR: 3.25, 95% CI: 1.97-5.35; P < 0.00001) and patients with partial remission (RR: 5.39, 95% CI: 3.25-8.93; P < 0.00001). In addition, there were more patients with at least 50% improvement in the Bath Ankylosing Spondylitis Disease Activity Index score in the experimental groups (RR: 3.07, 95% CI: 2.44-3.86; P < 0.00001). Most adverse events in both treatment groups were mild or moderate in severity.
Anti-TNF(a) agents is an effective and well-tolerated treatment for reducing clinical symptoms of AS.
本研究旨在探讨抗肿瘤坏死因子（TNF）（依那西普、英夫利昔单抗、戈利木单抗或阿达木单抗）在强直性脊柱炎（AS）中的疗效。
使用 PubMed、Embase 和 Cochrane 数据库进行文献检索。检查所有原始研究的参考文献部分以获取其他参考文献，并且仅将那些报告比较依那西普、英夫利昔单抗或阿达木单抗与安慰剂治疗 AS 患者的随机对照试验结果的研究纳入本分析。
纳入了 11 项共 1851 例患者的试验。与安慰剂相比，抗 TNF（α）药物与较高的 ASAS20 应答率（风险比 [RR]：2.45，95%置信区间 [CI]：2.13-2.82；P < 0.00001）、ASAS50 应答率（RR：3.77，95% CI：2.87-4.95；P < 0.00001）、ASAS70 应答率（RR：3.25，95% CI：1.97-5.35；P < 0.00001）和部分缓解患者（RR：5.39，95% CI：3.25-8.93；P < 0.00001）相关。此外，实验组有更多患者的 Bath 强直性脊柱炎疾病活动指数评分至少改善 50%（RR：3.07，95% CI：2.44-3.86；P < 0.00001）。两组的大多数不良反应均为轻度或中度。
抗 TNF（α）药物是一种有效且耐受良好的治疗方法，可减轻 AS 的临床症状。
